A tight focused review of the key points from the LLSA 2017 ABEM reading list. Listen to the audio and take the attached quiz (in PDF form) and you will be ready for the ABEM LLSA test. LLSA 2017 - Introduction Paper 1 - Palliative Care Paper 2 - Aortic Dissection Paper 3 - Angioedema Paper 4 - Calcium Channel Blocker Overdose Paper 5 - Deliriu ...…

This is a preview of our coming soon EM:RAP board review course called CrunchTime, July 2018 Legionella Lyme Disease Malaria Tetanus Jennifer Farah, MD • Jessica Mason, MD • Mel Herbert, MD MBBS FAAEM

Darren Braude gets us prepared for another shortage, this time it's Ketamine. EM:RAP 2018 April Short - Ketamine Shortage Anand Swaminathan, MD FAAEM • Darren Braude, MD

It's April, and this month Mel and Stuart cover, SCIWORA, Chance Fractures, RA in the ED, Lactate, Insulin OD, Vertigo, Kinship and more. Introduction Lactate Community Medicine Rants – N of 1 Randomized Trial The Patient with Rheumatoid Arthritis in the ED Pharmacology Rounds – Antibiotics for STI Annals of Emergency Medicine – Influenza Testi ...…

In this episode of C3, we review an approach to younger patients with chest pain. C3- Chest Pain in Young Patients - Introduction C3 - Chest Pain in Young Patients - Pneumothorax C3 - Chest Pain in Young Patients - Pulmonary Embolism C3 - Chest Pain in Young Patients - Pericarditis and Myocarditis C3 - Chest Pain in Young Patients - Methampheta ...…

This month, Jan Shoenberger and Ramin Tabatabai review 30 articles. Mel and Vanessa give us their Ultra Summary and Jerry Deep Dives on a selection of this months abstracts. Rick Rants about opioid addiction treatment in the USA (or the lack thereof) and Ken talks a little nerdy about BRUE (Brief Resolved Unexplained Events). Jerry is joined by ...…

Zack Shinar and Joe Belezzo with a response to the October 2017 - Cardiology Corner – What REALLY Works in Cardiac Arrest segment EM:RAP 2018 March Hotpocket - Why Cardiac Arrest Research is So Tough Anand Swaminathan, MD FAAEM • Joe Belezzo, MD • Zack Shinar, MD

This month we cover Knee Dislocations, Pediatric UTI, Perforated Eardrum, Rhabdomyolysis, Intoxicated Patients, Mass Sociogenic Illness and more. Introduction Cardiology Corner - Computers Suck at EKG Paper Chase 1 - The Loop Technique When Ultrasound Is Not Your Friend Paper Chase 2 - NG Tube Decompression for SBO Trauma Surgeons Gone Wild - W ...…

In this episode of C3, we review an approach to patients with sore throat. The causes of sore throat range from benign and self-limited to life threatening airway obstructions. We will discuss a basic approach to patients with sore throat, the warning signs for life threats, and the management of low acuity pharyngitis. C3 - Sore Throat - Intro ...…

For the March EMA episode Jan Shoenberger and Billy Mallon tackle 30 great papers. Vanessa Cardy joins Mel Herbert for the Ultra Summary and Jerry Hoffman again Deep Dives a selection of this month’s abstracts. Rick Bukata rants about surprise medical bills and Ken Milne talks a little nerdy about assessing suicide risk in the ED. Jerry Hoffman ...…

Steroids in Sepsis and EMRAP is BACK at a Live Conference! February 2018 - Hotpocket - Steroids in Sepsis Anand Swaminathan, MD FAAEM • Mel Herbert, MD MBBS FAAEM

The February EMA Episode begins with Jan Shoenberger, Stuart Swadron and Ramin Tabatabai introducing the episode and reviewing the contents. Jan Shoenberger and Ramin Tabatabai then discuss this month’s 30 abstracts. This is followed by Mel and Stuart’s Ultra Summary and Jerry’s Deep Dive. Rick Rants about drug prices in the United States while ...…

Sometimes we all need to pause. Introduction The Quiet Chest in Trauma Paper Chase 1 – Repeat Head CT in Anticoagulated Trauma Cardiogenic Shock in Acute MI: The Basics Strayerism - The Pause Chlorine Gas Inhalation Paper Chase 2- Just Enough Ketorolac Science of Expertise Annals of Emergency Medicine - Risk Stratifying Febrile Infants HEART in ...…

In this episode of C3, we review the management of the patient with transient ischemic attack (TIA). C3 - TIA - Introduction C3 - TIA - Initial Assessment C3 - TIA - What Should Be Done In The Emergency Department C3 - TIA - What Else Should Be Done and DIsposition C3 - TIA - Summary Jessica Mason, MD • Mel Herbert, MD MBBS FAAEM • Stuart Swadr ...…

Dr Mason reviews the fact that we have an IV fluid shortage in North America after the recent hurricanes affecting Puerto Rico. January 2018 - Hotpocket - IV Fluid Shortage Jennifer Koehl, PharmD, BCPS • Jessica Mason, MD

Let's get this New Year started with some home cooked medical goodness that can only be EM:RAP. Introduction Origin of the HEART Score Paper Chase 1 – Nebulized Saline for Bronchiolitis Hyperbilirubinemia CTA vs MRA for Vertebral Dissection Paper Chase 2 – Dabigatran Reversal Cybersecurity Paper Chase 3 – Treadmills Get A Stress Test What is Ca ...…

In this episode of C3, we review the management of the patient with acute stroke. Although cerebrovascular disease is a leading cause of death worldwide, advances in acute stroke care have been overshadowed to some degree by advances in cardiovascular care. After years of slow and difficult progress, the battle against stroke is picking up stea ...…

EMA kicks off 2018 with a great episode full of clinically useful papers with our team of contributors tackling some hot topics. Jan and Ramin begin with their editors’ commentary on the January selections then Mel and Stuart give us a quick overview with their Ultra Summary. Jerry Hoffman’s Deep Dive looks at a few of this month’s papers with ...…

The dogma says never put epinephrine in the fingers, nose, penis, or toes, but is there evidence to support (or refute) that? Also in this short… Robbie O says farewell. Mythbusting Epi In The Digits Andrew Buelt, MD • Mel Herbert, MD MBBS FAAEM • Rob Orman, MD

The December EMA Episode begins with Jan Shoenberger and Billy Mallon discussing this month’s 30 Abstracts. This is followed by Mel and Stuart’s Ultra Summary and Jerry’s Deep Dive. Rick Rants about being a patient while Ken Milne brings us part 2 of his Managing ROSC lecture. Jerry reflects on P-Values and Mel takes a look at the history of re ...…

In this episode of C3, we examine the approach to the patient with a painful red eye(s). The causes of a painful red eye range from benign and self-limited to very serious and sight threatening. We will emphasize a methodical approach and discuss the skills and procedures that we need to be familiar with in the acute care setting. C3 - Painful ...…

It may be the final installment of EM:RAP for the year, but before we power down for a quick break. We baked up a special December that's full of warm chocolate, bundt cakey medical knowledge goodness. Introduction Cardiology Corner - The Things We Do for Chest Pain Part 2 Paper Chase 1 - A Better Tool to Exclude PE? Mark’s Story Diabetic Foot ...…

Mel and Rob discuss what's on the way for EM:RAP, a paper on opioid vs nonopioid analgesics for extremity pain, and challenge coins. November 2017 - Hotpocket Mel Herbert, MD MBBS FAAEM • Rob Orman, MD

In the November episode of EMA Jerry reflects on medical malpractice, censuring and standard of care, Rick rants about burn out, while Mel looks at the history of warming Lidocaine. Ken gives us part 1 of his lecture on managing ROSC, Jan and Ramin discuss their 30 selected abstracts for the month, Mel and Stuart summarize them all and Jerry se ...…

In this month’s C3, we discuss one of the most important and fascinating infectious diseases of our time - HIV/AIDS. The rapid spread of this global pandemic and its evolution from a universally fatal disease to one that can be controlled and prevented, is one of the most compelling stories in modern medicine. HIV and AIDS - Introduction HIV an ...…

George Willis is back for more DKA deep diving, but this time it’s the sickest of the sick. How long do we pause for ultrasound heart checks in cardiac arrest patients? Mike Mallin says too long. When creating a presentation, start with the story, that’s the P cubed way. There’s been a lot of talk about lysis of intermediate risk PEs but new ev ...…

Lessons Hard Learned In The First Year As An Attending October 2017 - Hotpocket Alan Sielaff, MD • Mel Herbert, MD MBBS FAAEM • Rob Orman, MD

Mel gives an update and insight on what's happening at EM:RAP. BackPassage October 2017 Mel Herbert, MD MBBS FAAEM

This month’s EMA episode includes Reflections of a Skeptic: The History of EMA, That Was Then This is Now: Magnesium in ACS, Time To Talk A Little Nerdy: TIAs, Rick's Rants: Fluoroquinolone Black Box Warning, Jerry’s Deep Dive, The Ultra Summary, and 30 abstracts. Introduction Abstract 1 - Parent-Reported Penicillin Allergy Symptoms in the PD A ...…

Atrial fibrillation (AF) is the most common tachyarrhythmia. As such, AF is bread and butter for the emergency provider. We need to really understand and be comfortable with this rhythm. Atrial Fibrillation - Introduction Atrial Fibrillation - History and Exam Atrial Fibrillation - Rhythm Control Atrial Fibrillation - Rate Control Atrial Fibril ...…

This is a historic month, the month Emergency Medical Abstracts joined EM:RAP! The historic series with 30 plus papers and all new commentaries is now part of EM:RAP, are you kidding me! It also means a new app and web site! Say what! It is the return o da Captain and his Little Ozzie Friend, if only for the month. Also includes: Notes from Uga ...…

You’ve probably seen the news story: an ED nurse is handcuffed by a Utah detective for refusing to draw blood on an unconscious accident victim. Nobody wants something like this to happen, but are we compelled to act as agents of the police for evidence collection? Legal experts Scott DeShields and Rich Orman weigh in. September 2017 - Hotpocke ...…

How should we approach seizures in pediatric patients? How different is this from adults with seizures? We will discuss. Seizures in Pediatric Patients - Introduction Seizures in Pediatric Patients - History, Exam, and Workup Seizures in Pediatric Patients - Status Epilepticus Seizures in Pediatric Patients - Febrile Seizures Seizures in Pediat ...…

Your next patient is altered and blue. Blue as a blueberry. What on earth could be happening? We travel to the backwoods of the American south to find out. Isn’t it time the Framingham risk factors got a remodel? Amal says yes, but the bigger question might be, “Do we care?” A painful tooth that doesn’t look infected, is there an indication for ...…

In our AMA segment this month, it was stated that a patient who leaves the ED against medical advice is at risk for their insurance company not paying the bill. We have been inundated with emails saying, “Is that really true? I heard it was a myth…” It turns out that this IS a myth! Thank you for helping us set the record straight. Listen in fo ...…

Mel Herbert MD, Christine Moutier MD, Ramin Tabatabai MD, and Matthieu DeClerck MD touch on suicide risk in physicians. How did we get here and now what do we do about it? Suicide Risk in Physicians Christine Moutier, MD • Matthieu DeClerck, MD • Mel Herbert, MD MBBS FAAEM • Ramin Tabatabai, MD

Rob and Swami kick things off with a case of a patient with a red hot arm who ends up with a surprising diagnosis. Having trouble placing that Foley cath? Not to worry, Jess does a cognitive biopsy of our urology consultant for a bevy of tips and tricks. Vitamin C might not cure the common cold, but can it save septic patients? How often to we ...…

Seizures frighten everybody. They can be distressing not only for patients but also for their families, public bystanders and even emergency providers. Because the convulsions associated with seizures can be so dramatic, we tend to lose our ability to think in a logical manner when a patient is actively seizing. In this episode of C3, we cover ...…

First some information on the FIX conference with the FEMinEM people. Mel presents ANOTHER case of a sick patient in a plane and lesson learned, and a challenge coin winner Dr. John C. Maino, MD July 2017 Hotpocket Mel Herbert, MD MBBS FAAEM • Stuart Swadron, MD FAAEM

In last month’s C3, we discussed the concept of primacy of rate. Simply stated, the more abnormal the heart rate, the more likely that it is responsible for the patient’s symptoms. In most cases (but not all - e.g. not in hypothermia and myxedema coma) intervening to correct the rate is a high priority in the resuscitation. Bradycardia P1-Initi ...…

When it comes to preoxygenation, consider the Nigel Tufnel approach of turning the amp up to 11. How much do we really know about OTC analgesics? Delaney is back with some surprising news. Weingart solves the puzzle- how much lack does lactate lack if lactate lacks lactate? There are all sorts of meds we give to ACS patients, but do they do any ...…

It seems like the more we know, the less we do. Rob and Mel review two articles in the ‘less is more’ category June 2017 - Hotpocket Mel Herbert, MD MBBS FAAEM • Rob Orman, MD

Managing patients with tachycardia is as central to emergency medicine as airway, breathing, and circulation. In many cases, a rapid heart rate is the most prominent and obvious part of a patient’s presentation – and in some cases it demands immediate action from the treatment team. In this episode of C3, we have attempted to make the approach ...…

We are masters of working in malodorous conditions. But just because we can tolerate the toxic sock, doesn’t mean we have to. Strayer soothes the hulk. Is the Hare Traction Splint useful? Amal breaks down the ‘warranty’ on different cardiac studies. Stuart and Billy get super funky with an obs case gone bad. How long do we need to obs a pt who ...…

Our recent segments on stoke updates and naloxone dosing have set off a storm of controversy! May 2017 - Hotpocket Mel Herbert, MD MBBS FAAEM • Rob Orman, MD

Epistaxis, or nosebleed, is among the commonest presentations to the emergency department. Although epistaxis occurs in the majority of people at some point during their lives, most are minor and self-limited. Those patients who arrive to the ED represent a specific subset of nosebleeds - ones that won’t stop. These patients may be quite anxiou ...…

Do you discuss anxiety with your low risk chest pain patients? Jeff Kline says it might not be a bad idea. Kenji and Miz demystify the penetrated extremely. Stroke care continues to evolve, Ryan Radecki tells us how. Is that red, swollen leg really infected, or is a case of pseudocellulitis. Tim Horeczko dissects the tests for septic joints in ...…